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In This Issue:
Researchers from BWH’s Division of Global Health Equity have been hard at work around the globe, from Haiti to Peru, to right here in Boston. The following projects represent just a few of the ways they are working to improve care through research and education around the world.
Demonstrating Cost-Effectiveness of Early Antiretroviral Therapy for HIV Patients in Haiti
BWH researchers, together with Weill Cornell Medical College and GHESKIO (Groupe Haitien d’Etude du Sarcome de Kaposi et des Infections Opportunistes), have shown that early treatment of HIV not only saves lives, but is also cost-effective.
The researchers sought to evaluate if the revised World Health Organization’s recommendation to start antiretroviral therapy (ART) in HIV patients earlier than previously thought was cost-effective and if its benefits outweigh its costs. Using data from a previous randomized clinical trial in Port-au-Prince, Haiti, the researchers compared the cost-effectiveness of early vs. standard ART. They found that patients who received early ART had higher average costs for ART but lower costs for other aspects of their treatment than patients who received standard ART.
“These findings suggest that, in Haiti, early ART is a cost-effective intervention over the observation period of the trial,” said lead author Serena P. Koenig, MD, of the Division of Global Health Equity.
NIH Sponsors Ambitious Study of TB Transmission in Peru
Socios En Salud Perú, an affiliate of Partners In Health, has been conducting an ambitious study to determine precisely how tuberculosis is transmitted. Although it is well-established that overcrowding and poor diet contribute to TB transmission, particularly in poor neighborhoods, the study “Epidemiology of Multidrug-Resistant Tuberculosis in Peru” (The EPI Project) examines a broader question and seeks to ascertain why some people have greater resistance to infection than others. The project’s principal investigators are Megan Murray, MD, and Mercedes Becerra, MD, of BWH’s Division of Global Health Equity, who proposed conducting the study in Lima, Peru, and secured the multi-million-dollar grant to fund it.
“We want to understand why some people contract tuberculosis while others who live in the same home and eat the same food don’t; why some appear to have greater resistance [to the illness] than others; why some don’t become sick for one to two years while others have TB symptoms just weeks or months after their first contact with an infected person,” said Leonid Lecca, MD, the study’s principal investigator in Lima.
The need to find answers to these questions is the basis for this project, which is financed by the National Institutes of Health.
Global Health Delivery Case Studies Available
This summer, the Global Health Delivery project—a collaboration among BWH, Harvard Medical School and Harvard Business School—released 21 teaching cases and accompanying teaching notes examining the principles of health care delivery in resource-poor settings.
Paul Farmer, MD, PhD, chief of BWH’s Division of Global Health Equity, said, “The publication of these cases—online, and freely accessible to the practitioners, students and educators who will benefit most from them—is an important step toward closing the know-do gap in global health. Increasingly, our feedback loop of research, teaching and service is directly strengthening the care we deliver on the ground and our ability to replicate and scale successes.”
These teaching case studies are available to global health educators, students and practitioners at no cost through Harvard Business Publishing. Access the case studies online at www.ghdonline.org/cases